| NPI | 1972644243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: AL D-7825-C) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: MD D60206) |
| 1223E0200X Dentist Endodontics (Licence: CT 007822) | |
| 1223E0200X Dentist Endodontics (Licence: NC 00168) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2021-09-09 |