| NPI | 1538130265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: OH 35098919) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: NY 234023) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35098919) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2016-07-05 |