NPI | 1588391759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 12361) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D14820) |
Enumeration Date | 2022-08-06 |
Last Update Date | 2025-08-14 |