| NPI | 1689231060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12013824A) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.026096) |
| 122300000X Dentist (Licence: IL 019.032276) | |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2022-12-30 |