| NPI | 1114906187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AL 5599) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: TN DS7698) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2016-02-22 |