NPI | 1154555035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN123170) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DTP618) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 8715) | |
204E00000X Oral & Maxillofacial Surgery (Licence: FL ME124338) | |
Enumeration Date | 2009-05-07 |
Last Update Date | 2024-02-20 |