| NPI | 1700044237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 74078) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 1002522-15) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA OMS84) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 054147) | |
| 208600000X Surgery (Licence: CA A103339) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2024-04-25 |