| NPI | 1225052467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: OH 34.017043) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.017043) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: VA 0102202652) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102202652) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2024-10-02 |