| NPI | 1457481582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009722) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12209722) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2018-04-17 |