| NPI | 1407078124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN 15718) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NY 048686) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2021-06-07 |