| NPI | 1649695537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: CA CA36250) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: CA 36250) |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2022-07-21 |