| NPI | 1457399818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: OH 35.090077) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 235185-1) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2025-12-01 |