| NPI | 1407581788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12013805A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.033673) |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2022-07-20 |