| NPI | 1245324698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology Pediatric Radiology (Licence: OH 35.072722) |
| Additional Taxonomies | 2085P0229X Radiology Pediatric Radiology (Licence: KY 36941) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-09-20 |