| NPI | 1811244791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN23144) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: TX 30798) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2020-11-24 |