| NPI | 1689884587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: OH 35095572) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: MI 4301087766) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2016-04-26 |