| NPI | 1457388092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KS 61603) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 57309) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2004017440) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2020-09-29 |