| NPI | 1780663666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN27693) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NY 048695) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2023-02-17 |