| NPI | 1760545156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: UT 22020819923) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 44527) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2022-10-19 |