| NPI | 1295742070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12007396) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12007396A) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2014-09-29 |