| NPI | 1013007491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009154) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 11814) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2023-06-27 |