NPI | 1487867990 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 12299) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA CA23480) |
Enumeration Date | 2007-05-08 |
Last Update Date | 2024-05-08 |