| NPI | 1548044233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 12348) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC DGD.10642) |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-09-08 |