| NPI | 1538352059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 43537-20) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME88208) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: NJ 25MA09894200) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: DE C1-0010587) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: IL 036148465) | |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2021-12-07 |