NPI | 1487926341 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 147230-1205) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: UT 147230-1305) |
Enumeration Date | 2012-02-07 |
Last Update Date | 2012-02-07 |