| NPI | 1700865896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.072317) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35072317) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2022-10-06 |