NPI | 1093260366 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WI 1001454-15) |
Additional Taxonomies | 122300000X Dentist (Licence: IN 12012588A) |
Enumeration Date | 2016-08-16 |
Last Update Date | 2017-01-26 |