| NPI | 1396980611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22DI02391200) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 061438) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 10326) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NY 307534) | |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2024-08-11 |