| NPI | 1497916852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35123562) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036177493) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2025047025) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2026-01-07 |