| NPI | 1386741718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12006998B) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12006998) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2025-02-12 |