| NPI | 1427262161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 3997) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 874) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: KY 44995) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: AR E8873) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2015-10-16 |