| NPI | 1285168005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.145000) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 56794) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2024-02-21 |