NPI | 1225264054 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IN 12011708) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1855074) |
Enumeration Date | 2009-06-08 |
Last Update Date | 2012-10-12 |