NPI | 1811970700 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: DE G10000865) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: PA DS021814L) |
Enumeration Date | 2005-11-23 |
Last Update Date | 2007-07-08 |