| NPI | 1194818484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35086925) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35-86925) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2013-12-04 |