| NPI | 1861980757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN123300) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN DS0000010741) | |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2024-03-11 |