| NPI | 1295416139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: KS 929) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 62079) |
| 122300000X Dentist (Licence: NJ 22DI02950800) | |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2024-07-16 |