| NPI | 1043959273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL D.007616-C1) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC DGD.10211) |
| Enumeration Date | 2022-06-04 |
| Last Update Date | 2026-07-16 |