| NPI | 1184771032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.094832) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.094832) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA 37465) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2013-03-12 |