| NPI | 1659327534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: OH 35.048988) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.048988) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35048988) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2019-10-15 |