| NPI | 1467616391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: OH 35) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: LA 331295) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2022-08-10 |