| NPI | 1285086645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12012599A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12012599B) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901022014) | |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2021-01-17 |