| NPI | 1467442822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: OH 35.074135) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: KY 35593) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.074135) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX L5353) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2023-11-06 |