NPI | 1740209006 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35062021) |
Additional Taxonomies | 208D00000X General Practice (Licence: OH 35062021) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2016-08-30 |