| NPI | 1285895789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02426000) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 054429-1) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02426001) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02426005) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2018-01-17 |