| NPI | 1619032836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: HI DT-2405) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 7062) |
| 1223G0001X Dentist, General Practice (Licence: HI DT-2405) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2023-04-28 |