| NPI | 1881126159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IN 12013479) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CO DEN.00203924) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2021-01-10 |