| NPI | 1992374268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0438000533) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MS 4202-21) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401419410) | |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2025-07-14 |