| NPI | 1922446426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30.026082) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 9961) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH RES.3324) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2020-06-02 |