| NPI | 1396901567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OK 6071) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 6071) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2008-08-06 |