| NPI | 1770631137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN14578) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: PA DS024170L) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2021-01-28 |