NPI | 1972730695 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN28947) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 019-030536) |
Enumeration Date | 2009-06-20 |
Last Update Date | 2024-06-12 |