| NPI | 1801001466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-088260) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD036934) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.088260) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 236242) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2025-06-20 |