| NPI | 1245290238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.021953) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 21953) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2022-05-12 |