| NPI | 1548462526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011372A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-025967) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2012-10-25 |