NPI | 1275742629 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35095538) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301083683) |
2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2009-00763) | |
Enumeration Date | 2007-05-22 |
Last Update Date | 2013-12-09 |