NPI | 1114157187 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 30-023216) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019028059) |
Enumeration Date | 2009-07-23 |
Last Update Date | 2014-02-18 |