| NPI | 1437293917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: OH 35 096754) |
| Additional Taxonomies | 2085N0904X (Licence: OH 35096754) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: KY 46554) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35 096754) | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2023-11-08 |