| NPI | 1073950143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: NV S9-03) |
| Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: HI DT-2536) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2024-06-05 |