| NPI | 1285914028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MD 11004) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: DC DEN5423) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2011-08-25 |