| NPI | 1285073700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN27423) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D008752) |
| 1223E0200X Dentist, Endodontics (Licence: MN D13301) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2023-02-07 |