| NPI | 1144614991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 11192) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN 21352) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 62996) | |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2022-08-23 |