| NPI | 1982769121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: FL DN26613) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: NJ 22DI01896800) |
| 1223P0700X Dentist Prosthodontics (Licence: MA DN18602) | |
| 1223P0700X Dentist Prosthodontics (Licence: NY 045430) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2022-05-18 |