| NPI | 1144510827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ 22DI02964900) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 063039) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2023-11-29 |