| NPI | 1346215175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35-05-0079-L) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: OH 35.050079) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2016-03-07 |