| NPI | 1548944465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 10945) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12014121A) |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-06-12 |