NPI | 1811970254 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12010004) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 7213) |
204E00000X Oral & Maxillofacial Surgery (Licence: IN 12010004) | |
204E00000X Oral & Maxillofacial Surgery (Licence: KY 7213) | |
Enumeration Date | 2005-11-21 |
Last Update Date | 2014-11-21 |