NPI | 1891908661 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: DC 2923) |
Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: VA 4170) |
1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: MD 5621) | |
Enumeration Date | 2007-05-08 |
Last Update Date | 2007-07-09 |