| NPI | 1972697019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: KS 60398) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 60398) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-12-08 |