NPI | 1194724013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35067965) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU M-2125) |
Enumeration Date | 2005-07-21 |
Last Update Date | 2018-09-21 |