| NPI | 1851596530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: TX P7288) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: TX P7288) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: OK 25650) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P7288) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 25650) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2024-03-13 |