NPI | 1144756792 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: OH 30.025978) |
Additional Taxonomies | 122300000X Dentist (Licence: IN 12012674A) |
Enumeration Date | 2017-05-02 |
Last Update Date | 2021-04-20 |