| NPI | 1598107567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TN 9716) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN20285) |
| 122300000X Dentist (Licence: TN DS0000009716) | |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2019-07-08 |