NPI | 1740356435 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: NJ 8422) |
Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: NJ 2047) |
Enumeration Date | 2006-11-27 |
Last Update Date | 2007-07-08 |