| NPI | 1437306032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P5991) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME118970) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.099537) | |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2025-05-01 |