| NPI | 1417407875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12013941A) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 398416) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2024-02-12 |