NPI | 1437648292 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: LA 7500) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS041940) |
204E00000X Oral & Maxillofacial Surgery (Licence: LA 7500) | |
122300000X Dentist (Licence: PA DS041940) | |
Enumeration Date | 2018-05-08 |
Last Update Date | 2024-08-06 |