| NPI | 1699391953 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12013425A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.032629) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2024-05-23 |