NPI | 1669691200 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 48487) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: AL 30138) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN17902) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 5224) | |
204E00000X Oral & Maxillofacial Surgery (Licence: CA A128233) | |
Enumeration Date | 2007-04-24 |
Last Update Date | 2015-02-11 |