NPI | 1699901868 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: MO 2009013156) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2009013156) |
204E00000X Oral & Maxillofacial Surgery (Licence: KS 60883) | |
2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: MO 2009013156) | |
Enumeration Date | 2009-06-02 |
Last Update Date | 2020-11-19 |