NPI | 1730104407 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: HI DT-2316) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS035178) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2011-04-12 |