NPI | 1265532477 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NJ 22DI01878200) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: WA 7269) |
Enumeration Date | 2006-09-25 |
Last Update Date | 2017-11-16 |