| NPI | 1700934874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR E2963) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 3353) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2002002452) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: AR E2963) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: AR 3353) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MO 2002002452) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2012-04-26 |