| NPI | 1598827016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: OH 35.145242) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME107275) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.145242) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 46077) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL TRN10232) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2025-10-14 |