| NPI | 1932427317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TN 53940) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5850 C1) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 10028) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: TN 10028) | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2016-07-05 |