NPI | 1457589228 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN 20364) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019.027935) |
Enumeration Date | 2009-06-30 |
Last Update Date | 2013-09-16 |