| NPI | 1154550010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: AL MD.43630) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: PA MD455368) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2022-12-24 |