| NPI | 1467773911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: IN 12011459A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12011459A) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2023-02-02 |