| NPI | 1912269572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IN 12012116) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN LDR120009) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2018-03-17 |