| NPI | 1548349202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: HI dt-0-2898) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DIO2299400) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 6227) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2023-02-24 |