| NPI | 1497201073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: IN 12012528A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012528A) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2023-03-08 |