NPI | 1023470184 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NH 04647) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DL12973) |
Enumeration Date | 2016-03-27 |
Last Update Date | 2021-10-12 |