NPI | 1922100379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NH 6297) |
Additional Taxonomies | 122300000X Dentist (Licence: NH 01684) |
Enumeration Date | 2006-09-05 |
Last Update Date | 2017-03-01 |