| NPI | 1033132295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.090700) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01058498) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D66060) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2022-05-04 |