NPI | 1063395994 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: DE C7-0018679) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: FL 41417) |
Enumeration Date | 2025-07-29 |
Last Update Date | 2025-07-29 |