| NPI | 1164473633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology Pediatric Radiology (Licence: NY 294755) |
| Additional Taxonomies | 2085P0229X Radiology Pediatric Radiology (Licence: NM 294755) |
| 2085P0229X Radiology Pediatric Radiology (Licence: FL ME 130137) | |
| 2085P0229X Radiology Pediatric Radiology (Licence: PA MD424673) | |
| 2085P0229X Radiology Pediatric Radiology (Licence: CA C132104) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD424673) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA C132104) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2024-08-07 |