| NPI | 1316505191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: KY 11093) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IN 12014689a) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2026-07-13 |