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 |