| NPI | 1538324660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: WI 2154) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: IL 036152598) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: NY 263793) | |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2023-06-23 |