| NPI | 1427168756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN28880) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: NJ 22DI 023174) |
| 1223E0200X Dentist, Endodontics (Licence: NJ 22DI 023174) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-12-09 |