NPI | 1932427317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TN 53940) |
Additional Taxonomies | 122300000X Dentist (Licence: AL 5850 C1) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 10028) | |
204E00000X Oral & Maxillofacial Surgery (Licence: TN 10028) | |
Enumeration Date | 2010-05-11 |
Last Update Date | 2016-07-05 |