NPI | 1538492707 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 40392) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: CA A72867) |
Enumeration Date | 2009-09-06 |
Last Update Date | 2009-09-06 |