| NPI | 1760492953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AR 3100) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: TN 7022) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2012-08-09 |