| NPI | 1689613887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: KY 7082) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IN 12010338) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2021-01-12 |