NPI | 1659374288 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 9501196) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: NC 9501196) |
Enumeration Date | 2005-05-27 |
Last Update Date | 2015-08-18 |