NPI | 1487742094 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 049440) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 23119) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12011777a) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 6853-15) | |
Enumeration Date | 2006-10-10 |
Last Update Date | 2014-12-23 |