| NPI | 1548294556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35-055716) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35055716) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2011-07-26 |