| NPI | 1679566533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AZ D011232) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CO 8711) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2023-06-12 |