NPI | 1598014037 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.024137) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12011798A) |
Enumeration Date | 2012-08-30 |
Last Update Date | 2022-09-23 |