NPI | 1285014084 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TX 32373) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2901021581) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL D-0007036-C) | |
204E00000X Oral & Maxillofacial Surgery (Licence: AL 42397) | |
204E00000X Oral & Maxillofacial Surgery (Licence: TX U5913) | |
Enumeration Date | 2015-06-05 |
Last Update Date | 2024-06-24 |