| NPI | 1437253531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: OH 35080063) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: KY 38815) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2023-09-18 |