| NPI | 1407996804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: PA MD430747) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: PA MD430747) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2013-04-18 |