| NPI | 1891223202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 11242) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN22571) |
| 1223G0001X Dentist, General Practice (Licence: GA DN122603) | |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2024-05-26 |