NPI | 1639337645 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12011142A) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12011142A) |
Enumeration Date | 2008-05-27 |
Last Update Date | 2020-12-16 |