| NPI | 1316938004 |
|---|---|
| Former Name | PRABHUSHAMAPPA VEERASETTAPPA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS020617Y) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 51753) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2007-07-08 |