NPI | 1093766354 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: DE C10004138) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C10004138) |
2085P0229X Radiology, Pediatric Radiology (Licence: PA MD019886E) | |
2085P0229X Radiology, Pediatric Radiology (Licence: NJ MA06748500) | |
Enumeration Date | 2006-05-12 |
Last Update Date | 2011-09-26 |