| NPI | 1194980391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IN 12011585A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12011585A) |
| 122300000X Dentist (Licence: MD 15060) | |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2024-10-16 |