| NPI | 1295904431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: OH 35.093545) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: OH Training Liscense) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2009-05-27 |