| NPI | 1275577850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: MO 113275) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: KS 05-39181) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2025-12-23 |