NPI | 1548222730 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NM DD5435) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 055981) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KS 60516) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 36927) | |
Enumeration Date | 2006-04-04 |
Last Update Date | 2023-01-25 |