NPI | 1013280676 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TN 12468) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CA 58799) |
Enumeration Date | 2012-02-13 |
Last Update Date | 2025-07-14 |