| NPI | 1457482168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 36125) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL DN10933) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2022-07-21 |