| NPI | 1386898096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.126719) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 51371-20) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2015-06-22 |