| NPI | 1891226114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.145694) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125070957) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125070957) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2022-06-03 |