| NPI | 1487206041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12013746A) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS042460) |
| 122300000X Dentist (Licence: KS 61731) | |
| Enumeration Date | 2019-07-14 |
| Last Update Date | 2024-05-30 |