NPI | 1396123352 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401416435) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 16193) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DC DEN1001975) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2019016472) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 19032524) | |
Enumeration Date | 2015-05-11 |
Last Update Date | 2022-09-15 |