| NPI | 1760595748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: OH 35 065052) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35065052) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2018-02-20 |