| NPI | 1184716938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: VA 0101264628) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: DE C10007905) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: DE C10007905) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C10007905) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD419063) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2021-07-30 |