| 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) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY P69996) | |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2024-05-22 |