| NPI | 1609805357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN 14665) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MD 13483) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2010-04-30 |