| NPI | 1801058276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN23175) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401412191) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL 23175) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401412191) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2022-06-14 |