| NPI | 1437389525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12011781A) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: ME 4117) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2013-04-29 |