| NPI | 1245247436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-091781) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 00-38557) |
| 207T00000X Neurological Surgery (Licence: OH 35-091781) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-04-01 |