| NPI | 1245428556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CO 8124) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CO 0008124) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2022-07-21 |