| NPI | 1073587689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 58056) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.122503) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0033888) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2023-09-07 |