| NPI | 1588729164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IN 12010930A) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IN 12010930A) |
| 1223G0001X Dentist General Practice (Licence: IL 019027139) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2021-02-22 |