| NPI | 1295035020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: ID D-4318-EN) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: WA DE 60171338) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2010-10-27 |