| NPI | 1235752601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12014260A) |
| Additional Taxonomies | 122300000X Dentist (Licence: NM DD5292) |
| 122300000X Dentist (Licence: AZ D010747) | |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2024-02-26 |