| NPI | 1043411283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 5023) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 58.002032) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2012-04-03 |