| NPI | 1396125944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12012295A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12012295A) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 10390) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2020-01-06 |