| NPI | 1669462958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD479323) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: UT 11931633-1205) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: PA MD479323) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 11931633-1205) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01058718A) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2023-08-30 |