| NPI | 1043660285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: CA A190243) |
| Additional Taxonomies | 2085N0700X (Licence: IL 036.156760) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.069247) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 76856-20) | |
| Enumeration Date | 2016-06-19 |
| Last Update Date | 2023-10-13 |