| NPI | 1093959660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS043962) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 8795/879) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 8644) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12012234A) | |
| 122300000X Dentist (Licence: NC 8644) | |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2023-05-28 |