NPI | 1134899446 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: IN 12013703A) |
Additional Taxonomies | 122300000X Dentist (Licence: KY 10695) |
122300000X Dentist (Licence: VA 0401417584) | |
Enumeration Date | 2021-09-17 |
Last Update Date | 2023-06-01 |