| NPI | 1285731869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NH 3437) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: RI DEN02940) |
| 1223E0200X Dentist, Endodontics (Licence: MA 21204) | |
| 1223E0200X Dentist, Endodontics (Licence: NY 051694-1) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2007-09-25 |