| NPI | 1437490182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN26544) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22DI02809900) |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2021-11-17 |