| NPI | 1154749174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: OH 35.127332) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.127332) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2026-01-24 |