| NPI | 1447512421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN21883) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12011814A) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2016-08-25 |