| NPI | 1497923981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CT 009888) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: RI DEN03000) |
| 1223E0200X Dentist, Endodontics (Licence: MA 21730) | |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2008-07-01 |