NPI | 1528554466 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NE 34965) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: NE 34965) |
Enumeration Date | 2018-07-03 |
Last Update Date | 2023-11-21 |