NPI | 1851596803 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NY 054210-1) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: NJ 22di02418800) |
Enumeration Date | 2007-06-19 |
Last Update Date | 2013-04-17 |