| NPI | 1871723817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: TN 9620) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: AL 5697) |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2019-01-25 |