NPI | 1174313803 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NH 05247) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2025-05-07 |
Last Update Date | 2025-07-27 |