NPI | 1639736176 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IN 12014617A) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 061151) |
122300000X Dentist (Licence: CO 00205322) | |
Enumeration Date | 2019-05-21 |
Last Update Date | 2025-03-18 |