| NPI | 1912129909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MI 2901019067) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IN 12010491A) |
| 1223E0200X Dentist, Endodontics (Licence: AL 5254) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-07-08 |