| NPI | 1346324001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS 4334-22) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 51011) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS OR-6028-22) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2023-04-17 |