| NPI | 1013335223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 7268-15) |
| Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: WI 7268-15) |
| 122300000X Dentist (Licence: WI 7268-15) | |
| 1223D0001X Dentist, Dental Public Health (Licence: WI 7268-15) | |
| 1223P0700X Dentist, Prosthodontics (Licence: WI 7268-15) | |
| 1223X2210X Dentist, Orofacial Pain (Licence: WI 7268-15) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 7268-15) | |
| 1223E0200X Dentist, Endodontics (Licence: WI 7268-15) | |
| 1223P0300X Dentist, Periodontics (Licence: WI 7268-15) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 7268-15) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2025-11-06 |