| NPI | 1831453125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: HI DT-3112) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 011166) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2023-12-08 |