| NPI | 1144482738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 123411) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 257295) |
| 2085N0700X Radiology Neuroradiology (Licence: MD D76133) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2014-10-26 |