| NPI | 1881604817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: OH 35.053642) |
| Additional Taxonomies | 2085R0001X (Licence: OH 053642) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-01-06 |