| NPI | 1265880199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CT 13326) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: RI DEN03597) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2022-08-23 |