| NPI | 1902006000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12013063A) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037845) |
| 122300000X Dentist (Licence: IA DDS-09285) | |
| 122300000X Dentist (Licence: IL 19027468) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2019-03-14 |