| NPI | 1396891073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: CO DR.0047706) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CO 47706) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2018-11-17 |