| NPI | 1952542185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NH 03699) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: NH 14303) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2019-03-13 |