NPI | 1831402635 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: PA MT207536) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI L1553542) |
Enumeration Date | 2010-07-21 |
Last Update Date | 2014-07-16 |