| NPI | 1437280583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30-024004) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS031233) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: PA DN000685) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2021-12-27 |