| NPI | 1518349497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12012679A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1001133-15) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2021-03-08 |