| NPI | 1326375247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: NJ 22DI024331300) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: OH 30-022703) |
| Enumeration Date | 2009-11-13 |
| Last Update Date | 2010-02-19 |