| NPI | 1972587897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35 029469) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: OH 35 029469) |
| 2085N0700X Radiology, Neuroradiology (Licence: OH 35 029469) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: OH 35 029469) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2008-09-23 |