NPI | 1821131145 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: OH 30.016069) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NM DD1380) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 16069) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30.016069) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12009837A) | |
Enumeration Date | 2007-02-15 |
Last Update Date | 2024-03-22 |