NPI | 1245443746 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.010424) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 58-002217) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101019053) | |
Enumeration Date | 2007-05-08 |
Last Update Date | 2013-05-08 |