| NPI | 1538612056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: WI 4397) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 4397) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 266950) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-48434) | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2024-12-12 |