| NPI | 1881981439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401414602) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: TX 30377) |
| 1223E0200X Dentist, Endodontics (Licence: FL DN20884) | |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2018-05-15 |