| 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 |