NPI | 1902399710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085D0003X Radiology Diagnostic Neuroimaging (Licence: OH 34.016412) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 010066) |
2085R0202X Radiology Diagnostic Radiology (Licence: OH 58030691) | |
Enumeration Date | 2018-06-07 |
Last Update Date | 2023-06-18 |