NPI | 1356873939 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 57.253457) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME158909) |
Enumeration Date | 2017-04-01 |
Last Update Date | 2024-03-29 |