| NPI | 1275583791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-056294) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 44389) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2012-07-19 |