| NPI | 1891743043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 2901012196) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN D12196) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2025-09-11 |