| NPI | 1548437361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NJ 22DI02259000) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: PA DS036725) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2011-11-07 |