NPI | 1598738874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: KY 53439) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35082471R) |
Enumeration Date | 2006-02-08 |
Last Update Date | 2021-02-05 |