NPI | 1104865468 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: OH 35062100) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35062100) |
Enumeration Date | 2006-06-05 |
Last Update Date | 2022-05-19 |