NPI | 1366635203 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: KY 46357) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OH 35.092924) |
Enumeration Date | 2007-08-23 |
Last Update Date | 2022-08-18 |