| NPI | 1952830507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MI 2952000406) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: PA RFD000037) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2022-11-17 |