NPI | 1518207430 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NH 04561) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 060412) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA DN1858663) | |
Enumeration Date | 2013-03-01 |
Last Update Date | 2020-11-23 |