NPI | 1992957203 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS037951) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 050810) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22D102509200) | |
Enumeration Date | 2008-10-17 |
Last Update Date | 2014-11-18 |