| NPI | 1760063887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OH RES.004223) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: OH 30.026898) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2022-08-11 |