| NPI | 1083288153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12014372A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA DDS-09878) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2024-06-21 |