| NPI | 1992705891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 9711) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN14780) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN013908) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 938) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: ND 2180) | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2016-03-04 |