| NPI | 1255708723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: IN 12013046A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 9653) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2018-11-20 |