| NPI | 1174797203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-120971) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 322479) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2024-09-10 |