NPI | 1306126222 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME123437) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: CT 81727) |
2085P0229X Radiology, Pediatric Radiology (Licence: NJ 25MA10120700) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: CT 81727) | |
Enumeration Date | 2011-08-23 |
Last Update Date | 2025-08-06 |