| NPI | 1871027367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KS 61923) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IA DDS-10040) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NE 7789) | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2024-02-06 |