| NPI | 1346221108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IN 12010083) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IN 12010083A) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2019-11-26 |