| NPI | 1427004654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MA 13856) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: WA DE00006899) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2007-07-08 |