| NPI | 1881044105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12012778) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12012778A) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2023-10-13 |