| NPI | 1437185766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AR 3513 / 109) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 20901) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 7493) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-09-19 |