NPI | 1548462526 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011372A) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-025967) |
Enumeration Date | 2007-06-01 |
Last Update Date | 2012-10-25 |