| NPI | 1194080010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: WI 72408) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OH 35.151411) |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2024-07-19 |