| NPI | 1578710331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: ID D-4167-EN) |
| Additional Taxonomies | 122300000X Dentist (Licence: ID D-4167) |
| 122300000X Dentist (Licence: PA DS037626) | |
| 1223E0200X Dentist, Endodontics (Licence: UT 8121225-9922) | |
| 1223E0200X Dentist, Endodontics (Licence: UT 8121225-9921) | |
| 1223E0200X Dentist, Endodontics (Licence: SD D0934) | |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2017-10-26 |