| NPI | 1417268830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12012100B) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.028355) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2023-01-27 |