| NPI | 1386855070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: OH 35-099000) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY R1536) |
| 2085N0700X Radiology, Neuroradiology (Licence: NC 172984) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2017-02-14 |