| NPI | 1447324256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: KS 60239) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MO 2003011849) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-27 |