| NPI | 1336283902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: CO DR.0064656) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: KY 54370) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A120069) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA ML20008736) | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2023-05-19 |