| NPI | 1881880334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: TX 48102) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: MD D48391) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2024-05-22 |