| NPI | 1609106012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ID D-4483-PD) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 8147013-9923) |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2024-03-26 |