| NPI | 1073670550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN27784) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS036032) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN015542) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS036032) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 9048) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2023-08-30 |