| NPI | 1316093099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: CA C55867) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.093795) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR-45318) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 23770) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 6957491-1205) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C55867) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2024-04-08 |