| NPI | 1336795079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MA DN1858403) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: HI DT-3326) |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2026-09-02 |