| NPI | 1891933875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NV S7-117C) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 035694) |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2021-08-25 |