| NPI | 1326261058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401411948) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 14011) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DC 1000620) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: DC MD036657) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MD D66183) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2009-09-02 |