| NPI | 1588942841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 38894) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL DN9581) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2023-03-29 |