| NPI | 1194246942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IN 12012740A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012740A) |
| Enumeration Date | 2017-07-02 |
| Last Update Date | 2020-07-31 |