NPI | 1104211309 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35.141235) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 281871) |
Enumeration Date | 2015-04-03 |
Last Update Date | 2024-06-05 |