| NPI | 1235446055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CT 10336) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: NJ 22DI02628500) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2024-08-02 |