| NPI | 1255444220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35067471) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 9836) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2008-05-22 |