NPI | 1992989818 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30-022217) |
Additional Taxonomies | 122300000X Dentist (Licence: OH 30-022217) |
Enumeration Date | 2007-12-27 |
Last Update Date | 2007-12-27 |