NPI | 1679093603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 16449) |
208600000X Surgery (Licence: MD D0096480) | |
Enumeration Date | 2017-06-21 |
Last Update Date | 2023-03-09 |