NPI | 1043538705 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS038552) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: PA MT207339) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VT 016.0125577) | |
Enumeration Date | 2010-05-05 |
Last Update Date | 2017-01-20 |