NPI | 1659365559 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: NC 38857) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 38857) |
Enumeration Date | 2005-09-07 |
Last Update Date | 2007-07-08 |