| NPI | 1336880913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: AR 28) |
| Additional Taxonomies | 122300000X Dentist (Licence: AR 4795) |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2026-08-20 |