| NPI | 1598287617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12012788A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012788A) |
| 1223G0001X Dentist, General Practice (Licence: IN 12012788A) | |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2024-06-04 |