| NPI | 1366635203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: KY 46357) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OH 35.092924) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2022-08-18 |