| NPI | 1144890542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 061839) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NJ 22DI02799400) |
| 1223E0200X Dentist, Endodontics (Licence: FL DN24329) | |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2026-05-21 |