| NPI | 1184658569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN0012132) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL ME66211) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 14082) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 9948) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS026292L) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2007-07-08 |