NPI | 1932183340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: PA MD023594-E) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: PA 023594-E) |
Enumeration Date | 2005-11-30 |
Last Update Date | 2007-07-08 |