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 |