| NPI | 1467511642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN DS0000008035) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN DS08035) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2025-03-12 |