NPI | 1982977328 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.016920) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102203539) |
Enumeration Date | 2012-02-15 |
Last Update Date | 2024-02-08 |