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 |