NPI | 1740594571 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DE G3-0000378) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN123815) |
122300000X Dentist (Licence: OR D11020) | |
122300000X Dentist (Licence: AZ D008567) | |
1223G0001X Dentist, General Practice (Licence: SC DGD.10935) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D11020) | |
Enumeration Date | 2010-08-04 |
Last Update Date | 2025-06-30 |