| NPI | 1902594633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D14914) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12014119A) |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-06-21 |