| NPI | 1144401126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: MO 2021030368) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: KS 04-44807) |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2025-12-06 |