| NPI | 1760526735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: PA DS038305) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NJ 22di02281100) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2019-09-10 |