NPI | 1235406851 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 57.019682) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.019682) |
Enumeration Date | 2011-11-28 |
Last Update Date | 2018-02-21 |