| NPI | 1386617751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: TN 12978) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: AR 2) |
| 1223E0200X Dentist, Endodontics (Licence: AR 18) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2026-07-01 |