NPI | 1083187538 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: MD LL935) |
Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NY 061196) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-01-08 |
Last Update Date | 2025-02-10 |