| NPI | 1700225356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: HI DT 2468) |
| Additional Taxonomies | 122300000X Dentist (Licence: HI DT 2468) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2013-06-17 |