NPI | 1306250642 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: OR D10220) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12012144A) |
Enumeration Date | 2014-06-15 |
Last Update Date | 2018-04-19 |