NPI | 1578653317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: CA G60767) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G60767) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2024-04-05 |