| NPI | 1588243539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NJ 22DI02991000) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: PA DS044274) |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2023-08-07 |