| NPI | 1699980045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME112679) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: DE C100010066) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: PA MD434196) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T5549) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301081606) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2022-04-18 |