| NPI | 1295755296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AK 133) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK 1103) |
| 122300000X Dentist (Licence: MD 9566) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2008-04-10 |