| NPI | 1497985659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MI 2901020090) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL DN18681) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2013-01-31 |