| NPI | 1831464148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 10055) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12012993A) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: IN 12012993a) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: KY 10055) | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2022-06-23 |