| NPI | 1942399985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI01401000) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS023239L) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2024-08-29 |