| NPI | 1497167431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: KY 1084) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012612A) |
| 122300000X Dentist (Licence: FL DN20554) | |
| 122300000X Dentist (Licence: TN 9825) | |
| 122300000X Dentist (Licence: KY 9431) | |
| Enumeration Date | 2014-05-26 |
| Last Update Date | 2020-03-03 |