NPI | 1598991762 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 630272) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MT 6962) |
Enumeration Date | 2009-06-02 |
Last Update Date | 2009-06-02 |