| NPI | 1366557233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL dn15009) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: AL 2832) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2013-04-12 |