| NPI | 1316226087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 7455) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 35081) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2024-01-04 |