| NPI | 1952429946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: ID D-3556-en) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D13926) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-10-03 |