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 |