| NPI | 1750438792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009948) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D10779) |
| 1223G0001X Dentist, General Practice (Licence: AK 144144) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-25 |