| NPI | 1346692787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: AR 4422) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DR03038) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22dr03038) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 4422) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 06921) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22D102662800) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22D102662801) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22D102662802) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 06921) | |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2021-03-10 |