| NPI | 1437808318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 065378-01) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI03118000) |
| Enumeration Date | 2022-03-19 |
| Last Update Date | 2026-08-03 |