| NPI | 1306001920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN21631) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 8608) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: FL ME 120149) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2022-06-29 |