| NPI | 1275728768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: TX N6384) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: TX 41807) |
| Enumeration Date | 2007-09-08 |
| Last Update Date | 2024-05-09 |