NPI | 1033366463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: AZ 45805) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: AR E-18006) |
2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-18006) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 45805) | |
Enumeration Date | 2008-08-27 |
Last Update Date | 2024-09-25 |