| NPI | 1699941559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: AL 5814) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 8873) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2024-06-04 |