A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Neuroradiology | 2085N0700X |
| Diagnostic Radiology | 2085R0202X | |
| General Practice | 208D00000X | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
* Indicates primary specialty
| NPI Number | 1194168617 |
| Credentials | D.O. (Doctor of Osteopathic) |
| Entity | Individual |
| Enumeration date | 04/15/2013 |
| Last updated | 05/15/2026 - About 3 weeks ago |
| Sole proprietor1 | No |
| Identifiers |
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| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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