NPI | 1972738292 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.023184) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 2803) |
Enumeration Date | 2009-05-17 |
Last Update Date | 2025-06-09 |