| NPI | 1780993485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: IN 12011518A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12011518A) |
| 126900000X Dental Laboratory Technician | |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2024-04-23 |