| NPI | 1740364066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0438000212) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DE G10001119) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22DI02247000) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401411256) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS035695) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 8416) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2008-06-10 |