NPI | 1831623156 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL 28314) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WV 1001587-15) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-13 |
Last Update Date | 2023-08-21 |