| NPI | 1225238868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KS 60935) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO 1795) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: KS 60935) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2022-10-06 |