| NPI | 1750478590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 46338-020) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OH 35.092053) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2016-03-07 |