NPI | 1265962682 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IA DDS-10041) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NE 254) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NE 7798) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IA GA-0184) | |
Enumeration Date | 2017-06-18 |
Last Update Date | 2024-03-26 |