NPI | 1326465824 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CA CA64852) |
Additional Taxonomies | 122300000X Dentist (Licence: OH 30.025706) |
1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: OH 30.025706) | |
1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: OH 30.25706) | |
Enumeration Date | 2014-03-21 |
Last Update Date | 2020-10-01 |