NPI | 1497710214 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 2085P0229X Radiology Pediatric Radiology (Licence: CA C30322) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA C30322) |
Enumeration Date | 2006-04-18 |
Last Update Date | 2007-07-09 |