| NPI | 1700388014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 103524) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: HI DT-2960) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D15159) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 018.002073) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2024-08-22 |