NPI | 1740501329 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 127871) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2011012271) |
2085R0202X Radiology, Diagnostic Radiology (Licence: KY 49431) | |
Enumeration Date | 2010-06-17 |
Last Update Date | 2016-11-11 |