| NPI | 1407083744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35133145) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036137962) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2014-00690) | |
| Enumeration Date | 2009-06-13 |
| Last Update Date | 2019-06-19 |