NPI | 1831585454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 32967) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: TX 32967) |
Enumeration Date | 2015-04-09 |
Last Update Date | 2024-06-11 |