| NPI | 1093923666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 42273) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.149171) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2023-12-07 |