| NPI | 1669589222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AR 3040) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AR 3040) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2016-08-26 |