| NPI | 1518457001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TN 11718) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: HI DT-2862) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2024-09-11 |