| NPI | 1982791166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NJ 8340) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NY 026499) |
| Enumeration Date | 2006-10-07 |
| Last Update Date | 2012-08-08 |