| NPI | 1538412812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 61686) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 57020959) |
| 207R00000X Internal Medicine (Licence: OH 57020959) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.124091) | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2018-03-17 |