NPI | 1134502057 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NH 04610) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 31360) |
122300000X Dentist (Licence: PA DS040545) | |
Enumeration Date | 2015-07-09 |
Last Update Date | 2024-07-03 |