| NPI | 1538368204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD452039) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT190498) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OH 57-015488) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0076094) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35.121335) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2016-06-30 |