| NPI | 1952885840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12013007A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 10173) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2024-08-07 |