NPI | 1336669332 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 0000011452) |
Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: TN 0000011452) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-06-21 |
Last Update Date | 2022-07-21 |