| NPI | 1649511585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TN 11999) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D14322) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN015992) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 11999) | |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2024-11-07 |