| NPI | 1972706950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MT 5983) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL 13391) |
| 1223E0200X Dentist, Endodontics (Licence: MD 7795) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2016-03-31 |