NPI | 1033366463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: AZ 45805) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 45805) |
Enumeration Date | 2008-08-27 |
Last Update Date | 2018-01-16 |