| NPI | 1982830766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IN 01073950A) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: OH 30-023652) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IN 12011769A) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: OH 121183) | |
| Enumeration Date | 2009-06-07 |
| Last Update Date | 2014-07-02 |