| NPI | 1225658396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: TN 12412) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: GA DN123443) |
| Enumeration Date | 2020-04-19 |
| Last Update Date | 2024-07-08 |