| NPI | 1689929184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: OK 6433) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: OK 6433) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2021-02-12 |