| NPI | 1992295646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401418375) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: WA DE61171559) |
| 1223E0200X Dentist, Endodontics (Licence: TX 37946) | |
| 1223E0200X Dentist, Endodontics (Licence: GA DNF000434) | |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2024-07-09 |