| NPI | 1285711002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: PA DS022642L) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12009547) |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: IN 12009547) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-06-18 |