| NPI | 1235497975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IA 09513) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SD D1197) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IA 45169) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SD 11002) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 32567) | |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2024-03-07 |