| NPI | 1013085240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: TN 8659) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: SC 2860) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2008-07-31 |