NPI | 1922080993 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TN 51786) |
Additional Taxonomies | 125Q00000X Oral Medicine (Licence: TN 9764) |
Enumeration Date | 2005-11-16 |
Last Update Date | 2024-12-11 |