| NPI | 1992910301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: FL OS11789) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: DE C20010119) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: WI 53505) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: MA 235491) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL OS11789) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-09-17 |