| NPI | 1801037239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: AZ 43303) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 13195) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT186991) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 43303) | |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2017-09-22 |