| NPI | 1821364191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 04041418627) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: DC 1001719) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2023-09-26 |