| NPI | 1457502916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 8857) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN DS8857) |
| 122300000X Dentist (Licence: VA 0442000173) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 018.001702) | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2025-06-19 |