| NPI | 1811940166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: UT 10283260-1205) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: KS 04-34495) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: MO 2010015028) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 10283260-1205) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-10-22 |