| NPI | 1942434642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN13140) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN13140) |
| 1223E0200X Dentist, Endodontics (Licence: FL 13140) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2023-09-14 |