| NPI | 1699929521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME119417) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: DE C10011122) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0052411) | |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2022-07-21 |