NPI | 1144301342 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MA 37795) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: MA 37795) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MA 37795) | |
Enumeration Date | 2006-10-17 |
Last Update Date | 2007-08-20 |