| NPI | 1225268741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NJ 22DI02397900) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: PA DS037331) |
| 1223E0200X Dentist, Endodontics (Licence: AZ D7707) | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2009-07-17 |