| NPI | 1912226895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: TN TN9847) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: TN 9847) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: KY 11096) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2024-06-24 |