| NPI | 1235582792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12013104A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.032448) |
| 122300000X Dentist (Licence: FL DN22075) | |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2021-01-25 |