| NPI | 1053529883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101271687) |
| Additional Taxonomies | 2085N0700X (Licence: IL 036127653) |
| 2085N0700X (Licence: FL ME113834) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D67807) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME113834) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P8007) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2021-06-09 |