| NPI | 1962478529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-085959) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OH 35.085959) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2016-06-24 |