| NPI | 1063424893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-091352) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301068846) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2018-02-20 |