| NPI | 1083816185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME113938) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301088497) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.127262) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2014-03-21 |