| NPI | 1467421917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G63334) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.079417) |
| 207RM1200X Internal Medicine, Magnetic Resonance Imaging (MRI) (Licence: CA G63334) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA G63334) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2014-03-18 |