| NPI | 1952636417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085P0229X Radiology Pediatric Radiology (Licence: DC MD038359) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: DC MD038359) |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2011-12-19 |