| NPI | 1770022386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401417919) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MD 18921) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2025-09-16 |