| NPI | 1871571711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NM DD-1541) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 007583) |
| Enumeration Date | 2006-01-01 |
| Last Update Date | 2019-04-24 |