NPI | 1669541231 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: LA P-153) |
Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: LA P-153) |
Enumeration Date | 2006-11-07 |
Last Update Date | 2020-11-25 |