NPI | 1952754749 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: KY 9824) |
Additional Taxonomies | 122300000X Dentist (Licence: IN 12014346A) |
1223G0001X Dentist, General Practice (Licence: KY 9824) | |
Enumeration Date | 2016-07-18 |
Last Update Date | 2024-11-18 |