| NPI | 1346688181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: MI 4301103394) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301103394) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2019-06-25 |