| NPI | 1639152457 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 34005244P) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34005244) | 
| 2085B0100X Radiology, Body Imaging (Licence: OH 34005244) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: OH 34005244) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: OH 34005244) | |
| 2085H0002X Radiology, Hospice and Palliative Medicine (Licence: OH 34005244) | |
| 2085N0700X (Licence: OH 34005244) | |
| 2085N0904X (Licence: OH 34005244) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: OH 34005244) | |
| 2085R0001X (Licence: OH 34005244) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: OH 34005244) | |
| 207U00000X Nuclear Medicine (Licence: OH 34005244) | |
| 207UN0903X Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine (Licence: OH 34005244) | |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: OH 34005244) | |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: OH 34005244) | |
| Enumeration Date | 2005-11-25 | 
| Last Update Date | 2013-10-30 |