| NPI | 1972667160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 42940-20) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IA 37013) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 9125) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IA 08452) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MN S16) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: IA 37013) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: TN 43784) | |
| 208200000X Plastic Surgery (Licence: MN 58017) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TN 43784) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2018-08-27 |