| NPI | 1447552047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: TN 9890) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WV 3923) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2014-07-10 |