| NPI | 1497783161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME86986) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35-05-2264) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2015-08-10 |