| NPI | 1770523110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.051032) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 051032) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2026-08-19 |