| NPI | 1467526897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: KY 41802) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: KY 48202) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: VA 0101264122) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01070185A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35099660) | |
| Enumeration Date | 2006-11-18 |
| Last Update Date | 2019-08-23 |