| NPI | 1336260843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401411538) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WV 3585) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: VA 0401411538) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: WV 3585) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: VA 0401411538) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2016-12-12 |