NPI | 1295799989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NH 02155) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: ME DEN3558) |
Enumeration Date | 2006-04-12 |
Last Update Date | 2018-09-06 |