| NPI | 1033821046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12014278A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401418154) |
| Enumeration Date | 2022-12-21 |
| Last Update Date | 2023-12-08 |