| NPI | 1992851380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011752A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 7578) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-12-29 |