| NPI | 1730301649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NJ 220102077300) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NJ DI20773) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2011-04-13 |