| NPI | 1316332554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: DC DEN1001930) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MD 16698) |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2019-01-03 |