| NPI | 1275263758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 35.150422) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 57.256155) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2024-06-24 |