NPI | 1851475818 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NJ 22D101307400) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 0356441) |
Enumeration Date | 2006-10-25 |
Last Update Date | 2007-07-08 |