| NPI | 1831492370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35 125899) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.017894) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2016-05-27 |