| NPI | 1134250855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MS 2820-94) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS OS-339-00) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MS 16843) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MS 2820-94) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MS 16843) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2013-02-05 |