| NPI | 1225080203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-04-1898) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 15247) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2010-02-11 |