| NPI | 1255381000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35087047) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036154471) |
| 2085N0700X (Licence: CT 69458) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 69458) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2026-08-21 |