| NPI | 1942478318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: TX N2510) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N2510) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N2510) | |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2024-01-10 |