| NPI | 1366415838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: KY 03297) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX F8835) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2013-08-30 |