| NPI | 1194845222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 14203) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN012707) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DC DEN1000656) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2024-03-05 |