| NPI | 1649221128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AK 1445) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: KY 8195) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2022-09-29 |