| NPI | 1386617751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: AR 2) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: AR 18) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2014-10-02 |