| NPI | 1467892299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MD 16301) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: PA DS039611) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2023-06-23 |