NPI | 1760485858 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology Pediatric Radiology (Licence: TN 18854) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 18854) |
Enumeration Date | 2005-05-23 |
Last Update Date | 2016-05-04 |