| NPI | 1285815589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MS 3478) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 8114) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30.028230) | |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2026-04-28 |