| NPI | 1962670208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 1223G0001X) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12009809A) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-02-20 |