| NPI | 1114933538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: OH 35.037913) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: OH 35.037913) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2018-09-11 |