| NPI | 1326277708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OR D10376) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: WA DE60705325) |
| 1223E0200X Dentist, Endodontics (Licence: NY 055991) | |
| 1223G0001X Dentist, General Practice (Licence: MA DL10639) | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2023-10-18 |