| NPI | 1689343105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401418168) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: HI DT-2931) |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2022-12-04 |