| NPI | 1427212570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 34.010338) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 58.002404) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2017-04-12 |