| NPI | 1558410514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: AR N -7228) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR N - 7228) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2009-03-11 |