| NPI | 1194159095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CA A175281) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.134640) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A175281) | |
| 2085N0700X Radiology, Neuroradiology (Licence: KY 51639) | |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2024-04-08 |