| NPI | 1760441737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist Oral and Maxillofacial Pathology (Licence: NJ 22DI02115300) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: NJ 22DI02115300) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2016-05-03 |