| NPI | 1538494513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: OH 34.009731) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 05111) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2025-07-14 |