| NPI | 1114136165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TN 8923) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 5429) |
| 1223E0200X Dentist, Endodontics (Licence: KS 60501) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2009-02-19 |