| NPI | 1205213162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 83512) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58.006044) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 58.006044) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.128547) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2023-12-14 |