| NPI | 1952569923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL 23691) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: TX 26279) |
| 1223E0200X Dentist, Endodontics (Licence: CA 56765) | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2021-11-01 |