| NPI | 1255378196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35061693) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: OH 35061693) |
| 2085D0003X Radiology Diagnostic Neuroimaging (Licence: OH 35061693) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: OH 35061693) | |
| 2085H0002X Radiology Hospice and Palliative Medicine (Licence: OH 35061693) | |
| 2085N0700X Radiology Neuroradiology (Licence: OH 35061693) | |
| 2085N0904X Radiology Nuclear Radiology (Licence: OH 35061693) | |
| 2085P0229X Radiology Pediatric Radiology (Licence: OH 35061693) | |
| 2085R0001X Radiology Radiation Oncology (Licence: OH 35061693) | |
| 2085R0203X Radiology Therapeutic Radiology (Licence: OH 35061693) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: OH 35061693) | |
| 207U00000X Nuclear Medicine (Licence: OH 35061693) | |
| 207UN0903X Nuclear Medicine In Vivo & In Vitro Nuclear Medicine (Licence: OH 35061693) | |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: OH 35061693) | |
| 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: OH 35061693) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2012-04-04 |