| NPI | 1831843150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 064473) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN27129) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 14090) | |
| Enumeration Date | 2022-02-06 |
| Last Update Date | 2025-01-15 |