NPI | 1831754795 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TN 12449) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019.032265) |
Enumeration Date | 2019-05-07 |
Last Update Date | 2024-05-20 |