NPI | 1245608546 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN30921) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 32814) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401417810) | |
Enumeration Date | 2015-09-03 |
Last Update Date | 2025-08-26 |