| NPI | 1457736845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 11466) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 16589) |
| 1223G0001X Dentist, General Practice (Licence: IN 12012402A) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 16589) | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2022-09-15 |