| NPI | 1548044233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN31068) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2024018993) |
| 122300000X Dentist (Licence: NC 14012) | |
| 122300000X Dentist (Licence: TN 12348) | |
| 122300000X Dentist (Licence: SC DGD.10642) | |
| 122300000X Dentist (Licence: GA DN123322) | |
| 122300000X Dentist (Licence: AL D.007291-C1) | |
| 122300000X Dentist (Licence: WI 6001823-15) | |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2025-10-03 |