| NPI | 1053423301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12010902A) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 7875) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-12-06 |