| 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 |