| NPI | 1720031446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: KY 41082) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: PA MD420848) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: WI 46808-020) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: NE 21983) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: MN 42387) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: MI 4301053830) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: OH 35.043846) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: SC 28490) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: WA MD00047561) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2013-01-24 |