| NPI | 1033252937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 148) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: OK 5823) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2010-12-08 |