NPI | 1457354441 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009174) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019017190) |
Enumeration Date | 2005-05-24 |
Last Update Date | 2020-11-26 |