NPI | 1023202611 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: DE C7-0003672) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: PA MD433905) |
2085P0229X Radiology, Pediatric Radiology (Licence: DE C1-0008916) | |
2085P0229X Radiology, Pediatric Radiology (Licence: PA MT192173) | |
Enumeration Date | 2007-08-28 |
Last Update Date | 2012-01-18 |