NPI | 1740823657 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: IN 12013890A) |
Additional Taxonomies | 122300000X Dentist (Licence: OH 30.026615) |
122300000X Dentist (Licence: CA 104415) | |
Enumeration Date | 2019-10-23 |
Last Update Date | 2022-08-01 |