| NPI | 1326056599 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: AZ 30093) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 30093) | 
| Enumeration Date | 2006-08-04 | 
| Last Update Date | 2024-11-21 |