| NPI | 1386164531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.147857) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301111930) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-08-10 |