| NPI | 1912917238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN DS9672) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN011177) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 9672) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN11177) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2016-10-27 |