| NPI | 1619106242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: CO DR.0054260) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: IL 036.133390) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CA C174670) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ R71387) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: KY 55403) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2023-05-15 |