NPI | 1275013054 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MS 4001-18) |
Additional Taxonomies | 122300000X Dentist (Licence: MS 4001-18) |
Enumeration Date | 2018-08-21 |
Last Update Date | 2025-06-27 |