| NPI | 1851487433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401411059) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: AK 1223) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2012-10-08 |