NPI | 1831314202 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010951a) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 8369) |
Enumeration Date | 2007-04-13 |
Last Update Date | 2007-07-08 |