| NPI | 1285301168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12013930A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.026446) |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2023-04-10 |