| NPI | 1700877446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35 04 1992E) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OH 35 04 1922E) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2010-12-01 |