| NPI | 1093978538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036139673) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125054338) |
| 207R00000X Internal Medicine (Licence: NC 2012-00149) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2012-00149) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 262075) | |
| Enumeration Date | 2008-07-04 |
| Last Update Date | 2016-07-13 |