| NPI | 1891998134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02064100) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 0475191) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2007-07-08 |