| NPI | 1194010744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12011660) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: IN 12011660) |
| 1223G0001X Dentist General Practice (Licence: IN 12011660A) | |
| 1223G0001X Dentist General Practice (Licence: IN 12011660) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IN 12011660) | |
| Enumeration Date | 2011-06-11 |
| Last Update Date | 2019-06-03 |