NPI | 1841859535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: OH 30026175) |
Additional Taxonomies | 122300000X Dentist (Licence: OH RES.004082) |
Enumeration Date | 2019-06-06 |
Last Update Date | 2022-07-21 |