| NPI | 1801056171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.133178) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IN 01068285A) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2019-07-24 |