| NPI | 1538309737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 26482) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 46255) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.12694) | |
| Enumeration Date | 2009-02-27 |
| Last Update Date | 2024-04-18 |