| NPI | 1700298262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 4827) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ D9836) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2026-08-17 |