| NPI | 1841932654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12013950A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 38479) |
| 1223G0001X Dentist, General Practice (Licence: IL 019.034650) | |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2025-02-17 |