| NPI | 1679753602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NJ 22DI02348900) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NY 054783) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2016-03-31 |