| NPI | 1477849511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 105475) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12011786A) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 42000407A) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2025-10-23 |