| NPI | 1952446486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.090641) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: VA 0101253842) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2023-10-18 |