| NPI | 1710938220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35067354) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35067364) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2014-03-28 |