NPI | 1083871347 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: PA DS037719) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS037719) |
Enumeration Date | 2008-05-22 |
Last Update Date | 2017-01-27 |