| NPI | 1215241542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: CA A134719) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: CA A134719) |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A134719) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A134719) | |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2024-04-05 |