| NPI | 1326414103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IN 12012373A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012373A) |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2023-06-22 |