| NPI | 1043447402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-135455) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT194849) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 267540-1) | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2026-03-25 |