NPI | 1447822366 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12014286A) |
Additional Taxonomies | 122300000X Dentist (Licence: FL 25899) |
Enumeration Date | 2021-07-12 |
Last Update Date | 2024-01-05 |