| NPI | 1437685773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD480199) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: OH 35.145728) |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2023-10-03 |