| NPI | 1245735471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.014299) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 95508) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-08-28 |