| NPI | 1386954295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 10924) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5802C1) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 33799) | |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2022-11-28 |