| NPI | 1013064310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 3025) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22D102335600) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 16037) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN22477) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 22D102335600) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MO 2001031902) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: AR 3025) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: FL DN22477) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: TX 16037) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2023-05-12 |