| NPI | 1023054814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-086278) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A105533) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2021-11-29 |