| NPI | 1083657951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME97236) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 057513) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2013-08-28 |