NPI | 1285196451 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME168742) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.142269) |
Enumeration Date | 2019-04-04 |
Last Update Date | 2025-09-03 |