NPI | 1174675912 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IN 01048765A) |
Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IN 12009601A) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2010-12-30 |