| NPI | 1083758544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: TN 62366) |
| Additional Taxonomies | 2085R0001X (Licence: IL 036140023) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: FL ME104123) | |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2021-04-28 |