| NPI | 1760833768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AL D-0006738-C1) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 3881-16) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2022-06-08 |