NPI | 1790995207 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: TX P1072) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: OH 096808) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2012-08-21 |