| NPI | 1942730171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: FL DN26035) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: NJ 22DI02677600) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 06977) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: AR 4525) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: AR 4525) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: FL DN26035) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-07-06 |