| NPI | 1316381833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-53648) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.135419) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2026-08-17 |