NPI | 1316046899 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS18400) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OH 34.012588) |
2085P0229X Radiology, Pediatric Radiology (Licence: OH 34.012588) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.012588) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: CA 9181) | |
Enumeration Date | 2006-09-21 |
Last Update Date | 2023-03-30 |