| NPI | 1083685374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NH 03876) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22DI01811500) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 60194) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2011-11-09 |