| NPI | 1851500789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DE G6-0001211) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DE G3-0000374) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 26034) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: DE C1-0009455) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-03-18 |