| NPI | 1518161678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: AZ 37774) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 37774) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2018-03-29 |