| NPI | 1750617759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: PA MD438104) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: PA MT194358) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: DE C10009992) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME112084) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C10009992) | |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2023-12-11 |