| NPI | 1821183260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.008259) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: KY 02926) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: OH 34.008259) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2026-01-05 |