NPI | 1689888422 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35.144215) |
Additional Taxonomies | 208600000X Surgery (Licence: IL 125070699) |
Enumeration Date | 2007-05-10 |
Last Update Date | 2022-05-17 |