| NPI | 1477115822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02899700) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 13475) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 063728) | |
| Enumeration Date | 2019-07-06 |
| Last Update Date | 2025-05-08 |