| NPI | 1083956395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: OH 35.133035) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: NY 294307) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2020-08-19 |