NPI | 1346397239 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: AL AL28212) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL AL5271) |
Enumeration Date | 2007-01-04 |
Last Update Date | 2011-11-15 |