| NPI | 1205949237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12013290A) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 7330) |
| 122300000X Dentist (Licence: IN 12013290A) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2024-08-06 |