| NPI | 1437152378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: CO DR.0067049) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME94559) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CA C175197) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: KY 56015) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2023-05-15 |