| NPI | 1780130575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL D.007708-C) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: AL MD.54907) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2026-09-03 |