| NPI | 1740416379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD 1927) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: HI CSDT-14) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2014-02-07 |