| NPI | 1861921454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12013067A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019031181) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2018-11-07 |