| NPI | 1942273230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME108375) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35070522-M) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2025-05-01 |