| NPI | 1467690032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN9608) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL dn9608) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2018-02-22 |