| NPI | 1821130576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: HI DT-2353) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: KY 7902) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: HI MD-14911) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-10-28 |