NPI | 1700133840 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: OH 23579) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 23579) |
Enumeration Date | 2012-08-08 |
Last Update Date | 2012-08-08 |