| NPI | 1093974867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: OH 30-024214) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 71.000216) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 71000216) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2018-02-26 |