| NPI | 1659644888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 9492) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 9492) |
| Enumeration Date | 2012-02-19 |
| Last Update Date | 2024-04-24 |