| NPI | 1376668178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CT 005168) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CT 5168) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2015-06-02 |