| NPI | 1184152050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12014369A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA DDS-09391) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2025-04-30 |