| NPI | 1649252891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009906) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12009906A) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2020-08-28 |