| NPI | 1417158189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: DE G1-0001140) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: PA DS029819L) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2007-07-08 |