| NPI | 1952528010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TN 8925) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN-0017672) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2023-12-14 |