| NPI | 1518196039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN28662) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: HI DT-2589) |
| 1223P0300X Dentist, Periodontics (Licence: MD 14541) | |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2025-11-14 |