| NPI | 1841601556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MS 3742-14) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 3742-14) |
| 1223G0001X Dentist, General Practice (Licence: MS 3742-14) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2021-02-23 |