| NPI | 1356328306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: KY 6505) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: IN 12009306A) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2025-10-22 |