| NPI | 1285920447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: WV 30803) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD459972) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0080564) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35.082724) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2023-02-20 |