| NPI | 1225480809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NH 04818) |
| Additional Taxonomies | 122300000X Dentist (Licence: HI DT2643) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2024-04-23 |