| NPI | 1841499340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MS ENDO-441-11) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 3573-10) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2013-12-04 |