NPI | 1528201274 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: HI 1830) |
Additional Taxonomies | 122300000X Dentist (Licence: HI 1830) |
Enumeration Date | 2009-04-10 |
Last Update Date | 2009-04-21 |