NPI | 1164657896 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.129028) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI L254502) |
Enumeration Date | 2009-05-26 |
Last Update Date | 2021-08-17 |