| NPI | 1497986095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: ID D-4353-PR) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12011341A) |
| 122300000X Dentist (Licence: ID D-4353) | |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2017-05-25 |