NPI | 1851480628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12012871A) |
Additional Taxonomies | 122300000X Dentist (Licence: AL 4813) |
Enumeration Date | 2006-10-12 |
Last Update Date | 2018-03-17 |