| NPI | 1033228036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: OH 35.147537) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: LA 337604) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: WA MD00048258) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-08-14 |