| NPI | 1427266345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: AL 30619) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 5583) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 30619) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA 067560) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: GA 67562) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2015-07-25 |