| NPI | 1639160260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35 030121) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: OH 35030121) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2023-10-18 |