| NPI | 1447435359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CO DEN.00010273) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 12010975A) |
| 1223E0200X Dentist, Endodontics (Licence: IN 12010975A) | |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2015-01-03 |