| NPI | 1760556815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011926A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-017159) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2021-12-15 |