| NPI | 1093870529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010897A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-026809) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2013-07-17 |