| NPI | 1467485599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ D008845) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D008845) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN14533) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2025-06-18 |