| NPI | 1396713533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: OK 8692) |
| Additional Taxonomies | 2085N0904X (Licence: OK 8692) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2011-01-26 |