| NPI | 1437308756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: WA MD61606023) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME149942) |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2025-02-12 |