| NPI | 1083852669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: IN 12011162A) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: IL 019-023546) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-02-12 |