| NPI | 1437227782 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35062367) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01046785A) | 
| Enumeration Date | 2006-12-02 | 
| Last Update Date | 2023-12-20 |