| NPI | 1972571099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.085668) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA 435570) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301072096) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01060109A) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2013-10-09 |