NPI | 1992781512 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: PA DS024245L) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS024245L) |
Enumeration Date | 2005-12-15 |
Last Update Date | 2024-11-07 |