| NPI | 1265745384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: ME DEN4438) |
| Additional Taxonomies | 122300000X Dentist (Licence: ME DEN4438) |
| Enumeration Date | 2010-07-18 |
| Last Update Date | 2026-05-18 |