NPI | 1700404092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IN 12013381A) |
Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: IN 12013381A) |
171000000X Military Health Care Provider (Licence: IN 12013381A) | |
Enumeration Date | 2020-07-13 |
Last Update Date | 2023-08-07 |