| NPI | 1932834231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 12078) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MS 4317-22) |
| 122300000X Dentist (Licence: AR 4875) | |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2026-01-28 |