| NPI | 1366980096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NJ 06875) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NY 061034) |
| 122300000X Dentist (Licence: NJ 22DI02797500) | |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2023-01-26 |