| NPI | 1740422310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.125514) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2013-02259) |
| 207R00000X Internal Medicine (Licence: PA MT195349) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY R2074) | |
| Enumeration Date | 2009-03-29 |
| Last Update Date | 2021-10-05 |