| NPI | 1346405438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 59719) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL DN19186) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2017-03-17 |