| NPI | 1518993740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NH 03584) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 12780) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NH 03584) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2013-05-07 |