NPI | 1649572611 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TN 9220) |
Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: TX 25022) |
Enumeration Date | 2010-11-24 |
Last Update Date | 2010-11-24 |