| NPI | 1427210160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: CA A150446) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: MD D77532) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: DC MD042259) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: VA 0101255919) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2019-08-16 |