| NPI | 1356511596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME127571) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: KY 53085) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: WI 56281-020) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: OH 35.095104) | |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2023-11-08 |