NPI | 1992202261 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IN 12013413A) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D10968) |
Enumeration Date | 2018-04-12 |
Last Update Date | 2020-06-24 |