| NPI | 1427016799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: DE C10010568) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: PA MD428391) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME114675) | |
| 2085N0700X Radiology, Neuroradiology (Licence: FL ME114675) | |
| 2085N0700X Radiology, Neuroradiology (Licence: DE C10010568) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2013-08-23 |