| NPI | 1245258995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 34003170) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: OH 34003170) |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: OH 34003170) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2013-05-23 |