| NPI | 1861463390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: UT 6591903-1205) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: DE C10008795) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 84401) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CA G88982) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CO DR.0048702) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2024-01-10 |