NPI | 1497916001 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: TN 8858) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 8858) |
Enumeration Date | 2008-06-17 |
Last Update Date | 2020-11-10 |