| NPI | 1316046899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS18400) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OH 34.012588) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: OH 34.012588) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.012588) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 9181) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2023-03-30 |