| NPI | 1275588311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: OH 35 063041) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35063041) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2021-08-10 |