| NPI | 1578622908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL dn18554) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DTP477) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ D7521) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2012-10-19 |