| NPI | 1518218825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AZ D008585) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D008585) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2024-09-07 |