| NPI | 1164516662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 3759) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30-022361) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 77) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: AR 3997) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-04-15 |