NPI | 1841554524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A121789) |
Additional Taxonomies | 2085P0229X Radiology Pediatric Radiology (Licence: CA A121789) |
Enumeration Date | 2012-06-27 |
Last Update Date | 2012-06-27 |