NPI | 1295925071 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: MO 2024008876) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 44140) |
Enumeration Date | 2007-07-27 |
Last Update Date | 2024-10-30 |