NPI | 1629601679 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: TN 11770) |
Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: MS 4405-23) |
1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: AZ D012025) | |
Enumeration Date | 2020-02-18 |
Last Update Date | 2024-06-12 |