| NPI | 1033230701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 65909) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: OH 35.094440) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN NA) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.094440) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q6266) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-19 |