NPI | 1881919728 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: NY 00055621) |
Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: NJ 22DI02480400) |
122300000X Dentist (Licence: NY 00055621) | |
122300000X Dentist (Licence: NJ 22DI02480400) | |
Enumeration Date | 2010-04-04 |
Last Update Date | 2015-03-24 |