NPI | 1023211968 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN007001) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: GA DN007001) |
Enumeration Date | 2007-06-07 |
Last Update Date | 2007-07-08 |