NPI | 1699752758 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30-01-2211) |
Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: OH 35-031770) |
Enumeration Date | 2005-12-29 |
Last Update Date | 2007-07-08 |