| NPI | 1295981819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NY 50053789) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: IL 019026864) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2008-08-14 |