NPI | 1437291655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 8142) |
Additional Taxonomies | 122300000X Dentist (Licence: KY 8142) |
204E00000X Oral & Maxillofacial Surgery (Licence: KY 44040) | |
Enumeration Date | 2007-02-13 |
Last Update Date | 2018-08-07 |