NPI | 1295730562 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: AR 16) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 16) |
Enumeration Date | 2005-06-14 |
Last Update Date | 2014-06-02 |