| NPI | 1053457721 |
|---|---|
| Other Name | THADDEUS WILSON HERLICZEK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: MA 231919) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI 12603) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: DC MD500003109) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2025-01-17 |