NPI | 1952313892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 4301082697) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 4301082697) |
208600000X Surgery (Licence: MI 4301082697) | |
Enumeration Date | 2006-08-12 |
Last Update Date | 2025-08-26 |