| NPI | 1356379887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009301) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12010675) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2015-12-31 |