| NPI | 1437315272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 9943) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: KY 9943) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 332) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 9422) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2022-07-21 |