NPI | 1588778344 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.131775) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: SC 3962) |
Enumeration Date | 2006-08-18 |
Last Update Date | 2020-08-17 |