| NPI | 1639337645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12011142A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12011142A) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2020-12-16 |