NPI | 1598827016 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology Pediatric Radiology (Licence: OH 35.145242) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME107275) |
2085R0202X Radiology Diagnostic Radiology (Licence: FL TRN10232) | |
2085R0202X Radiology Diagnostic Radiology (Licence: OH 35.145242) | |
Enumeration Date | 2006-12-14 |
Last Update Date | 2024-10-02 |