| NPI | 1699783480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: OH 30-022269) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: IN 12010228B) |
| 122300000X Dentist (Licence: IN 12010228B) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2024-11-25 |