| NPI | 1326605957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: AZ 67632) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: OH 57.248269) |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2023-07-31 |