| NPI | 1891720728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DTP787) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2016042396) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 5272) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-06-06 |