| NPI | 1265657225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010741a) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 19026831) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2019-11-27 |