| NPI | 1619044724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IA 09480) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12013092A) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.025291) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901022957) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 8498) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 10380) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 36121) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 1001759) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN011369) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS042563) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2021-07-20 |