| NPI | 1275703308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AL 5539) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: GA DN013909) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2022-01-25 |