NPI | 1861690836 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-120945) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301090313) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MD D74002) | |
Enumeration Date | 2007-07-10 |
Last Update Date | 2015-12-30 |