| NPI | 1346446911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME113302) |
| Additional Taxonomies | 2085N0700X (Licence: AR E-5677) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: DE C10010212) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: AR E-5677) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2022-01-20 |