| NPI | 1427398866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: KY 10053) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IN 12013340A) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2020-07-08 |