| NPI | 1467457515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: LA MD.021258) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 18865) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2025-01-17 |