| NPI | 1689980237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 18345) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 35760) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 7747079-9921) | |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2024-08-26 |