| NPI | 1639105414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: PA MD039076E) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD039076E) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: DE C10010254) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2013-05-01 |