| NPI | 1144353467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12010964A) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 02985501) |
| 122300000X Dentist (Licence: NJ 9282) | |
| 122300000X Dentist (Licence: PA DS035365) | |
| 122300000X Dentist (Licence: VT 016 0002137) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2008-10-29 |