| NPI | 1023438835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MO 2018017241) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: IL 125.071554) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2018017241) | |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2022-07-25 |