| NPI | 1902254865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: HI DT-3041-0) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D009468) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2022-11-23 |