| NPI | 1780655548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G88289) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: AR N-7428) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CO DR.0048662) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: WI 52343) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: KY 41438) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: DE C10008907) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR N-7428) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 181755) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CA G88289) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-08-02 |