| NPI | 1699939702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 53208) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL DN16708) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2010-02-26 |