NPI | 1477554194 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35061993A) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME145117) |
Enumeration Date | 2005-08-03 |
Last Update Date | 2020-12-30 |