NPI | 1194462549 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 12123) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 10758) |
Enumeration Date | 2022-05-17 |
Last Update Date | 2023-02-28 |