| NPI | 1851738876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: HI DT-2448) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: LA 6378) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 29679) | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2016-12-21 |