NPI | 1568921807 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V6074) |
Additional Taxonomies | 2085R0001X (Licence: TX V6074) |
2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.017143) | |
Enumeration Date | 2019-03-17 |
Last Update Date | 2025-05-13 |