NPI | 1144547365 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D13351) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DE G3-0000383) |
Enumeration Date | 2010-04-27 |
Last Update Date | 2014-06-26 |